Acupoint hot compress lowers urine retention, uterine contraction discomfort after vaginal delivery: JAMA

China: After a vaginal birth, an acupoint heat compress reduced postpartum urine retention, uterine contraction discomfort, and depressive symptoms while increasing nursing milk production, says an article published in the Journal of American Medical Association (JAMA). 

Patients who have had a vaginal delivery may benefit from acupoint heat compresses in the early postpartum period, however evidence for this effect is limited. Yuhang Zhu and colleagues wanted to see if acupoint heat compresses incorporating the lumbosacral, abdominal, and plantar areas might reduce the incidence of postpartum urine retention, avoid mental problems, relieve postpartum uterine contraction pain, and stimulate lactation.

This multicenter randomized clinical study was carried out in 12 Chinese hospitals. Between January 17 and August 15, 2021, pregnant patients were examined for eligibility (n = 13 949) and enrolled following vaginal birth (n = 1200); data collection was concluded on August 18, 2021. Following vaginal birth, these women were randomly assigned to either the intervention or control groups. 

The statistical analysis was performed on a protocol-by-protocol basis. Control group participants got standard postpartum care. Within 30 minutes, 24 hours, and 48 hours following delivery, participants in the intervention group got regular postpartum care as well as three sessions of a 4-hour acupoint heat compress, including the abdominal, lumbosacral, and plantar areas.

The key findings of this study were as follows: 

1. The trial was completed by 1085 of the 1200 randomized participants.

2. When compared to the control group, participants in the intervention group had a significantly lower incidence of postpartum urinary retention, improved postpartum uterine contraction pain at 6.5 hours, 28.5 hours, 52.5 hours, and 76.5 hours after delivery, reduced depressive symptoms, and increased breastfeeding milk volume at 28.5, 52.5, and 76.5 hours after delivery. 

3. There were no adverse effects in either of the two groups. 

In conclusion, this clinical trial discovered that applying an acupoint hot compress to the abdominal, lumbosacral, and plantar regions reduced the incidence of postpartum urinary retention, reduced uterine contraction pain, managed to improve depressive symptoms, and continued to increase breastfeeding milk volume for women who had a vaginal delivery.

"Based on these findings, acupoint hot compresses might be used as an additional intervention in postnatal care to help patients with self-care," wrote the authors. 

Reference:

Zhu Y, Wang F, Zhou J, et al. Effect of Acupoint Hot Compress on Postpartum Urinary Retention After Vaginal Delivery: A Randomized Clinical Trial. JAMA Netw Open. 2022;5(5):e2213261. doi:10.1001/jamanetworkopen.2022.13261